Rim-enhancing left pleural collection with loculated left upper zone pleural fluid suspicious for empyema in this clinical setting, although it is possible that the pleural enhancement and loculation could also be secondary to recent VATS. Further clarification with FNA recommended.

Case Discussion

The CT findings were considered most likely to be due to infection or pulmonary oedema. There was no history of prior radiotherapy. Treatments for both infection and oedema did not result in either a clinical improvement or changes on imaging.

Her presentation was considered most likely due to COP; there were no indicators to suggest a pulmonary eosinophilic condition. Her symptoms slowly improved with steroid administration. No histology was ever obtained.